The drug use is another thing - Sherlock used cocaine and morphine. House used Vicodin. Morphine and Vicodin are both opioids.
If they had him abuse cocaine, it would be too unrealistic. If they had him abuse Adderall, it might not be obvious to audiences that he has a substance abuse problem - people could write it off as him using it to focus. A prescription opioid is something audiences understood were abused at the time, and maintains the Sherlock connections the writers were going for.
Plus it gives plenty of plot hooks to explore the effects and consequences of addiction to someone we believe to be very successful (success is happiness, right?) in season 1
The cocaine habit is probably exaggerated. Watson does not give a frequency of his usage and reports Holmes as saying that he only uses it when he doesn't have a case to occupy his mind. Whether this means he uses it a few times a week or a few times a year is not stated.
"Which is it today," I asked, "morphine or cocaine?" "It Is cocaine," he said, "a seven-percent solution. Would you care to try it?..."
You get used to the effects. House wasn't high. He was just addicted.
I strongly suspect mandatory opioid and cocaine testing in politics - never mind finance and law - would be a very good thing.
C'mon.
There's a huge difference between popping pills and having a local anesthetic. To even attempt to compare the two is being disingenuous at best. It's not even something prescribed to take home.